difficulties swallowing

introduction

For us, eating and drinking are processes of everyday life. If the food is chopped up in the mouth, the next step is the act of swallowing, which transports the pulp towards the stomach. "Swallowing" refers to the closure of the windpipe by the lid of the larynx. The background is that the food pulp from the mouth can in principle equally likely reach the trachea and esophagus. For this reason, the swallowing process seals the windpipe with the help of the larynx cover, so that the food only reaches the esophagus. This works almost 100% of the time.
If the swallowing process does not work, we choke and have to cough. The body then actively tries to push air upwards from the lungs in order to push the foreign body out of the windpipe. But what if it hurts to swallow and we have constant swallowing difficulties? Simple processes like eating and drinking hurt, sometimes the voice is impaired, and in the worst case scenario we cannot ingest any more food. The reasons behind this and what can be done about it should be clarified below.

Read more on the topic: Pain when swallowing

Symptoms

One speaks of swallowing difficulties when the Swallowing process impaired is hurting or not working. Symptoms are frequent choking, hoarse voice, red throat, and swelling. In some cases, swallowing can be so painful that it is no longer possible to eat, for example during a bacterial tonsillitis. Then those affected lose a lot of weight within a short period of time, which weakens the body and creates a kind of vicious circle. Complications from frequent ingestion include one Inflammation of the lungs, irritation of the vocal cords with a harsh, hoarse voice, and a sore throat.

One-sided / right-sided / left-sided complaints

Sore throats, swallowing disorders and swallowing difficulties in general can be caused by a number of different diseases.
However, if the symptoms are mainly or only one-sided, the list of possible causes is much shorter.

In principle, inflammatory processes in particular come into question here. Responsible for Pain when swallowing and a lump-like feeling on one side in the throat are usually the tonsils.
As one of the first barriers against pathogens, these are often inflamed and swollen even with simple flu-like infections. The flu infection (Colloquially known as the common cold) is one caused by quite harmless viruses (mostly rhinoviruses or adenoviruses) caused disease, which are typical symptoms Sore throat, sniff, to cough and / or causes swallowing difficulties, as everyone knows.

Real flu can also cause these symptoms.In contrast to the flu-like infection, however, it occurs at the same time as one that occurs suddenly Rise in fever and stronger General symptoms (Sore throat, difficulty swallowing, tiredness, body aches, etc..) connected. Depending on the location of the inflammation, one of these two inflammatory diseases can be Pharyngitis (Sore throat), laryngitis (Laryngitis) or Tonsillitis (Tonsillitis), each of which can cause unilateral swallowing difficulties. Influenza infections do not require treatment, especially since drugs such as antibiotics are ineffective against viruses. However, if necessary it is helpful such as pain medication Ibuprofen or Paracetamol to take.

However, bacterial problems are also very typical for unilateral swallowing problems Inflammation of the tonsilswhich are characterized by distinct pain when swallowing and white-yellowish purulent coatings (in contrast to viral inflammations, which are always pus-free) accompanied. The bacteria responsible are mostly group A streptococci. As a rule, the purulent tonsillitis takes a mild course, which can be treated very well, especially with antibiotics. In some cases, however, more serious secondary diseases can occur.
Especially worth mentioning is the Peritonsillar abscess. This is a local inflammation of the connective tissue surrounding the tonsils. This ultimately leads to the formation of a pus-filled abscess, which causes severe swallowing difficulties and a sore throat. This disease definitely needs medical treatment.

Since swallowing problems are often difficult to assess for the patient himself, swallowing disorders that last longer than a few days or severe pain when swallowing are always clarified by a doctor so that serious diseases can be excluded or treated in good time.

causes

For difficulties swallowing there are a wide variety of possible causes. The reasons can be divided into several different groups: old or young age, drug treatment, nerve and consecutive muscle failure, obstruction by foreign bodies, and physiological bottlenecks that impair the transport of the food pulp.

Age

Both high and low Age are influencing factors for swallowing difficulties. In old age slacken beside Muscles also receptors, and nerves. Stimuli are transmitted less well, and the initiation of the swallowing process works less well than before. It is no exception for elderly patients less appetite have like before. The food tastes and smells no longer as good as it used to, and is therefore no longer a great attraction artificial teeth, mouth pain, and frequent choking make the food unattractive.
But also in Toddler or childhood Difficulty swallowing can affect food intake. While the cause in older patients is mostly due to the "environmental variables", toddlers sometimes have not yet learned the correct swallowing process, or have never learned it properly. Both can lead to difficulty swallowing.

Medication

Another reason for difficulty swallowing, especially those with mental suffering are concerned is the medication. Neuroleptics - so "nerve-calming drugs" - are Medicationused for mental illnesses such as delusions, schizophrenia, and general agitation. One subdivides typical and atypical neuroleptics, whereby the "typical" belong to the somewhat older class of active ingredients. These cause so-called "Extrapyramidal disorders", that is, disorders in which the swallowing process is impaired. The pyramidal pathway is a nerve pathway that contains nerve fibers for the voluntary, that is to say deliberately influenceable, motor skills stroke be damaged. Extra-pyramidal disorders are disorders of the involuntary motor functionwhose job it is actually to control the pyramidal path. It is also responsible for involuntary, automated processes such as swallowing.
However, various typical neuroleptics impair the function of the extrapyramidal nerve pathways. After taking the medication, the patient then realizes that that Swallowing is no longer so easy as before, you yourself swallowed more often, and sometimes even too Mouth and tongue cramps comes. Therefore, a correct dosage of typical neuroleptics is important.
Out of this necessity, efforts were made to develop neuroleptics that cause less severe extrapyramidal side effects, and the "atypical "neuroleptics on the market. Your most famous representative is that Clozapine. In fact, a reduction in throat and tongue spasms was achieved, but they are not tolerated equally well by every patient and have a different, no less severe spectrum of side effects.

Nerve and muscle injury

Like any other movement of the body, the swallowing process involves a variety of Muscles necessary: ​​On the one hand, the pharynx is contracted via the throat, on the other hand the larynx is contracted on the esophagus pressed. Finally, the pulp has to be actively pushed into the esophagus, an approx. 40 centimeter long muscle tube. This makes it clear what a fine interplay of several muscles the swallowing process represents.
Come in mind muscle off, this can usually be compensated for by the remaining muscles, however, it comes to Multiple muscle damagethis results in difficulty swallowing or the inability to swallow. This can be done, for example, in the course of a Stroke be the case. Parts of the brain are damaged, the motor areas are often affected.
Certain nerve fibers run from the brain to the pharyngeal muscles, and are after you stroke "paralyzed". It is not for nothing that the ambulance service looks at the uvula in the mouth in case of suspicion in order to condense or refute any evidence of a stroke. But also after operations, or through tumorous infiltration can nerve pathways, and Muscles be harmed. An absolute warning sign for one stroke is next to swallowing difficulties "slurred", indistinct language.

Foreign body laying

Difficulty swallowing can also be caused by an obstruction of a foreign body. First and foremost, one thinks of a toddler who has choked on a toy, but even in adulthood there are a large number of causes for swallowing problems caused by foreign bodies in the throat and throat area. One of these causes is the so-called "Zenker's Diverticulum". That's what one calls one Bulge of the esophageal wall, with the formation of a small cavity that from now on attaches to the esophagus.
Along the esophagus is there three bottlenecks. The first is about 15 centimeters behind the teeth, in the neck area. A permanently too high pressure at this point leads to a bulging. Every time you eat food, food residues accumulate in this sac, which lead to swallowing, coughing and, above all, difficulty swallowing. In addition to these symptoms, there are often unpleasant ones Bad breath, and one Sensation of pressure and lump in the throat. But also one Tonsillitis, or infiltrating tumors in the throat and throat area can impair the swallowing process. The first clarification can be carried out at home: Using a hand mirror and a flashlight (often a cell phone also has a corresponding light source), you can shine astonishingly far into the mouth and throat area. You don't have to be an ENT doctor to determine that something looks "not normal"; comparing the sides of the right and left side of the neck often gives an indication. If there is any suspicion, a further examination will of course be carried out by the specialist.

Natural bottlenecks

As already mentioned, are on the way from mouth towards stomach three physiological, i.e. natural, constrictions through which the food pulp has to pass. The first bottleneck often leads to the development of Diverticula.
D.ie second bottleneck located just behind the heart, and typically can retrosternal Cause pain. Understandably, those affected are often afraid that it may be a problem of the heart. That's because the esophagus along the left atrium of the heart. At this narrow point, which is good 25 cm behind the row of teeth is then often a Sensation of pressure in the depths of the chestthat many to one Heart attack lets think. However, it is a gastrointestinal problem. A heart attack would also tend to announce itself with radiating pain in the left arm. This type of complaint is more common severe heartburn, belching, difficulty swallowing, up to and including vomiting of undigested food - A very uncomfortable state for the patient in the long run. However, it is relatively easy to clarify with the gastroenterologist, who then initiates appropriate therapy.

Difficulty swallowing due to tension

A number of diseases can be listed as the cause of swallowing difficulties. In addition to inflammatory processes in the mouth and throat, this also includes neurological diseases and disorders of psychological well-being.
In fact, in some cases, problems in the cervical spine (Cervical spine) causal. These are often summarized under the umbrella term of the cervical spine syndrome. In addition to the consequences of a whiplash or a herniated disc, this also includes functional tension in the neck muscles. These can cause a variety of symptoms such as sore throat and neck pain, swallowing disorders, dizziness, headaches, as well as visual disturbances and ringing in the ears.

Therapy for this tension is often protracted because it is based on chronic processes.
Likewise, it usually has to be individually tailored to the patient in order to be maximally effective. As a rule, so-called multimodal therapy approaches are used for the cervical spine syndrome.
In short, it is a form of therapy in which different treatment methods are combined with one another.
Both drug pain and muscle relaxation therapy and physiotherapy play an important role here.
Treatment methods such as heat therapy can also be helpful.

Read more about the topic here: Heat therapy.

Causes on the tonsils

Inflammation of the tonsils (Angina tonsillaris / tonsillitis) are one of the most common causes of difficulty swallowing. Mostly harmless viruses (in particular rhinoviruses and adenoviruses) in the context of influenza infections as a trigger. Typical symptoms like Sore throat, sniff, to cough and or Difficulty swallowing are the consequence.

In some cases, however, a real flu be the cause of swallowing difficulties. This leads to similar, but much more pronounced symptoms, as well as a sudden increase in fever and body aches.

However, bacteria can also be responsible for inflammation of the tonsils. These are mainly group A streptococci. These are carried through with the saliva Droplet infection, i.e. by sneezing, coughing and kissing, are transmitted and multiply in the lymphatic tissues such as the palate or tonsils when the immune system is weakened.
Children and young people in particular are affected by this. If necessary, treatment usually takes the form of drug pain therapy (for example with Ibuprofen or Paracetamol) and taking an antibiotic (e.g. penicillin).
In combination with bed rest, tonsillitis is usually easy to control and subsides within a few days if the antibiotic is consistently taken.

Complications

Earache

Complications from difficulty swallowing can besides Weight loss and food refusal also neck and Earache be. For this you have to know that the mouth and throat and the middle ear have a small cartilage tube that Tuba auditiva are connected. This cartilage tube is normally closed, but involuntarily opens when you swallow. This is for Pressure equalization, for example when flying: When the aircraft takes off and quickly gains altitude, one often feels an extremely uncomfortable feeling of pressure on the ears. This is because the ambient pressure in the room air no longer corresponds to the pressure in the middle ear.
By swallowing the Tuba auditiva - or "Eustachi tube" - are opened and pressure equalization takes place. However, if you have a cold and have a cold, the eustachi tube is often swollen shut, and the pressure on the ears becomes permanent. Result from it Headache, Hearing loss, and a seriously debilitating feeling of illness. Help to reduce swelling Nasal drops. But be careful when using: In this case, ear drops are useless because they do not get through the eardrum into the middle ear - this can only be reached via the oropharynx.
The connection between throat and Middle ear However, it is a curse and a blessing at the same time: Just as pressure equalization can take place via the Eustachi tube, so can bacteria and Viruses into the little cave behind the eardrum penetrate, and for one Otitis media to care. A middle ear infection rarely occurs on both sides, but mostly on the right or left. It does not matter whether the inflammation is on the right or the left, there is no difference in its course or treatment.
They are mostly antibiotic, decongestant Nasal drops administered, in extreme cases the eardrum must be opened so that pressure relief can take place.

Sore throat

To Sore throat it can occur relatively quickly with permanent swallowing difficulties. Finally, there is one in the throat area Variety of receptors and sensory cells that respond to the ongoing exposure to pain signals. This is one of the body's ways of signaling to the brain that something is wrong. However, a sore throat can also be the cause and cause difficulty swallowing. Once the throat swells up in the wake of a cold, swallowing is also more difficult. Since the swallowing muscles are located in the throat, it only seems logical that swallowing problems and sore throats are mutually dependent. What you against Sore throat and which home remedies are available are discussed further under "Therapy".

Difficulty swallowing when eating

Difficulty swallowing can have many causes. These include above all inflammation of the mouth and throat, but also neurological diseases which no longer lead to adequate innervation and thus control of the muscles involved in the swallowing process. Other causes include thyroid disorders, mental disorders, and of course Diseases of the esophagus in question.

Difficulty swallowing is particularly noticeable when eating and drinking and includes disturbances in the transport of food as well Pain when swallowing.

In order to get to the bottom of the cause of the difficulty swallowing while eating, medical advice is necessary in many cases, since, as described above, many areas of medicine, be it the ENT area or the neurological area, can be responsible.

therapy

Since difficulty swallowing can have a wide range of causes, it is important to first find the actual trigger. Often there is also a multifactorial complaint scheme not be ruled out. Against chronic processes, such as diverticula, Inflammation, or muscular changes usually more invasive therapies have to be chosen. Often there is no avoiding an operation. Support can be a Speech therapist, or one Swallowing therapy support the healing process.

For the classic swallowing difficulties that occur in the course of a cold, there are a number of effective ones Home remediesthat promise quick relief. An acute one cold therapy is best done with bed rest and lots of warmth. A scarf keeps the neck warm, hotter Camomile tea Sweetened with honey provides inner warmth. It is important that the tea is neither too cold nor too hot. As a guideline, you shouldn't be able to drink the cup in one gulp, but neither should you burn your tongue.If the eating does not work due to the difficulty swallowing, one can instead hot soup to be eaten.
Medicinal herbs how sage or thyme also have a pain-relieving effect and accelerate the healing process.
Another proven home remedy are those Quark wrap. To do this, you take commercially available quark, rub it about half a centimeter thick in a linen cloth, and wrap it around your neck. The curd should be around room temperature, and can be up to two hours stay on the neck. The procedure should be repeated once or twice a day become. However, as soon as the compress becomes uncomfortable or too cold, it must be removed.
Smoker should definitely stop smoking during the illness because of the ingredients of the cigarette local inflammation cause, and the Constrict blood vessels. This cools the throat and promotes inflammatory processes.

In addition to these home remedies, a visit to the house doctor or ENT doctor is inevitable in some cases. Suspicious swellings over weeks, a foreign body sensation and pus should definitely be clarified by a doctor. Behind you can be inflammation, even acute events like a stroke Tumors hide. A cure with home remedies is not possible in these cases.

forecast

As different as the causes of swallowing difficulties can be, the healing time also varies. With an ordinary one cold one is already after few days symptom-free, with one treated Tonsillitis at the latest within a week. Some diseases, like a stroke, however, require for years Rehabilitation training, and can cause discomfort a long time later. However, switching to another one often helps drug, or traditional Home remediesto achieve freedom from symptoms.